Pancreatogastrostomy vs pancreatojejunostomy after pancreaticoduodenectomy: An updated meta-analysis of RCTs and our experience

作     者：Yun Jin Yang-Yang Feng Xiao-Gang Qi Geng Hao Yuan-Quan Yu Jiang-Tao Li Shu-You Peng 

作者机构：Department of General Surgery the Second Affiliated Hospital College of Medicine Zhejiang University 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2019年第11卷第7期

页      面：322-332页

核心收录：

学科分类：10[医学] 

基　　金：Training Project of Health High Level Talents in Zhejiang Province 

主　　题：Pancreaticojejunostomy Pancreaticogastrostomy Systematic review Metaanalysis 

摘      要：BACKGROUND Pancreatoduodenectomy(PD)is one of the most important operations in hepatobiliary and pancreatic *** To evaluate the advantages and disadvantages of pancreaticojejunostomy(PJ)and pancreaticogastrostomy(PG).METHODS This meta-analysis was performed using Review Manager *** clinical randomized controlled trials,in which patients underwent PD with pancreaticodigestive tract reconstruction via PJ or PG,were *** The search of PubMed,Wanfang Data,EMBASE,and the Cochrane Library provided 125 *** further analysis,11 trials were included from nine *** all,909 patients underwent PG and 856 underwent ***-analysis showed that pancreatic fistula(PF)was a significantly lower morbidity in the PG group than in the PJ group(odds ratio[OR]=0.67,95%confidence interval[CI]:0.53-0.86,P=0.002);however,grades B and C PF was not significantly different between the two groups(OR=0.61,95%CI:0.34-1.09,P=0.09).Postoperative hemorrhage showed a significantly lower morbidity in the PJ group than in the PG group(OR=1.47,95%CI:1.05-2.06,P=0.03).Delayed gastric emptying was not significantly different between the two groups(OR=1.09,95%CI:0.83-1.41,P=0.54).CONCLUSION There is no difference in the incidence of grades B and C PF between the two ***,postoperative bleeding is significantly higher in PG than in *** PJ or binding PG is a safe and secure technique according to our decades of experience.